Has anyone had trouble w/civilian MDs not understanding the difference between a traumatic military wound and an 'old age' body problem?

I know this might sound some what odd pball, and I'm total perm disabled, so there's a limit to what I can suggest, I wasn't medical, I was allied health doctoral level, however, I assisted with carpal releases, my wife has carpal and tarsal tunnel syndromes, carpal is obv upper, tarso is the lower extremely equivalent, I just didn't know if you'd known, that was all...first, I'd seriously look at osteopathic manipulative therapy (OMT), done by DOs, osteopath, not MDs, only DOs do it, obv, the insurance rules for it can be quite arcane, find a local hospital with a walk in clinic, as private DOs doing OMT generally loathe insurance, I've wanted it for my wife for her lumbago forever, trust me, I trained with DOs, I wanted to go DO, I was never able the disability bollixed that up constantly, believe me, I tried...read about Andrew Taylor Still MD and OMT on Wikipedia...next, aside from PT and OT which you may doubtless likely have already tried, go for a rehab med/physiatrist, explicitly, also, go for anesthesiology/pain mgmt, you might he suitable for radio frequency (RF) ablation, possibly a block, there are injection techniques I was taught while in residency with no steroid, using only local anesthetic, that can help reduce pain spasm, that approach is being adapted now for PTSD, I'd read using what is termed a stellate ganglion block(SGV), I merely cite that as an example, in what I did, we were taught such techniques for sciatica frequently, that way, with no steroid, the object was to only use local, and reduce the paresthesia associated with sciatica, which seems I think, at least superficially to be what you're describing...next, if you haven't had electron total by (EMG) or nerve conduction velocity (NCV) studies, I expect you have, then have them, by neurology...EMG can be painful, I've watched it, it's invasive, whereas NCV isn't, as I recall, however, both are needed for a complete picture...next, ask for an MRI possibly with contrast, depending in your allergies, if dee!ed suitable in such a circumstance, you explicitly need a hand surgeon, now, there are both MD allopathic and DO osteopathic hand surgeons, as there are both in neurology, as well as rehab med/physiatry and also anesthesiology/pain mgmt, understand, not all DOs do OMT, all are trained in it in the US, however, as I said, the insurance rules for it can be pretty arcane, honest, so check first, gently hospitals tend to have walk in clinics, that typically take more insurances for OMT than private ofcs, I've noticed...further, a CT might he warranted aside from an MRI, however, being as you're describing a soft tissue problem, MRI might typically be deemed initially more preferable, also, many radios I trained under found MRI more sensitive than CT, however, both might he needed, given that you !mentioned shrapnel, wi the likely orthopedic consequences, whether a CT with contrast might he needed, honestly, that I can't judge, again, depending in your allergies if any to contrasts...also, petition BHA directly to have you expressly sent back to a regular svc hospital for explicit consult for a combat wound of you type, it should he possible, petition your Congressman and both Senators, to see if they can get VA to send you for just such a military consult, look at the website also http://www.amsus.org, for AMSUS, you'd find it quite useful, honest...look at the NIH Medline sites Entrez Pubmed this main one with paid articles, and also Pubmed Central, which is the free collection, no paid articles included...that's honestly as much as I can suggest...if you can get a second opinion, I'd most definitely insist on one, preferably at a major led ctr, specifically in a multidisciplinary setting, combining all the various specialties I'd mentioned, I'd also call VHA directly at VACO, and expressly describe your problem, that you're working outside is not sufficient reason to not make use of BA in my wiew, if need be, you can always be referred out to the med school affiliated with your local VA hospital, ask to see the chiefs of orthopedics, rehab med/physiatry, PT, OT, neurology, and anesthesiology/pain !GMT...see if your VA has any DOs on staff who do OMT, and ask explicitly for an OMT consult from all those svcsz incl the chief of staff of your VA hospital, through VA choice, to seek an OMT eval by DOs near you who do it, look up and call the AOA, the osteopaths analogue to the AMA, and also look up the AAOS and AANOS orthopedic boards, to see who is fellowship trained in hand surf in your area, don't just accept one opinion, in my view, always spread the word, and get multiple viewpoints, that's honestly the way I was always taught, honest, those are my views, such as they are, as I said, there's a fundamental limit to what I can suggest...also, the technique I'd described for paresthesias was something I was taught when I was in residency at a VA hospital for my disability, I merely !mention it to make you aware it exists, I do not know if it'd bensuited in your case for upper extremity, I was taught it for lower extremity, please understand that, I'm sure the one you're seeing is competent, however, my wife is as I might've already said, an orthopedic trainwrefk, so, believe me, I've been all over her stuff for years, to get her the care she needs...finally, there are physicians that do only acupuncture, they're rarez they supervise teams of acupuncturists, understand, physicians, who do only acupuncture, maybe with electrical stim, I'm sure you've been told of transcutaneous electrical nerve stim (TENS), there's also a new device called the Calmare, or Calmarett, a pain scrambler, it is not, repay, not, TENS, a local hospital near us has it, I've nagged my wife to go for it, one needs sevl trial runs to see if it has an effect, it uses a pain scrambler approach, generating a so capped nociceptive signal, which masked pain, look it up, trust me, it exists, it just may not be all that common where you are, that hospital by is is the only one near us I know if that has itz there are others around us, teyre just even further to get to, I found it an extremely interesting, and quite sophisticated approach, trust me, as I'd said, it most definitely is not TENS, I assure you, if I can answer anymore, I'll try, however, please understand, I a!, as I'd said, total perm disabled, we shut my doctoral level allied health license sevl urs ago, I just trained with all the fields I've related, while I'd been in grad school and in residency, plus, I've been around all that a long time, which is the only reason I know as !much about it as I do, I do not, repeat, do not, know what methods, of those I'd !mentioned, if any, might he suitable in your case, I merely a! Relating that info for you here, merely to try to inform you as well as try to help, as I found your problem of very real scientific interest, I'd wanted serious clinical research, however, the total perm disability got constantly in my way of being allowed yo do it, though, despite my disability, o try to not shut my Brian off, honest...if you'd care to chat further, I don't know how much more I can relate, those are my thoughts, such as they are for whatever they might he worth, I'd be most eager to know if any of it might he of any help, René!her, discuss all of those things with your internist and orthopedist, I only !mention those other fields as you see!, as I'd said, to have a multidisciplinary problem, at least from what I can discern, I hope it helps, at least to some extent, once again, I'd be !most eager to hear more, certainly, as well, whenever convenient....